Greater Trochanteric Pain Syndrome – Symptoms, Causes, and Treatment Options

Overview of Greater Trochanteric Pain Syndrome

Greater trochanteric pain syndrome is a common cause of outer hip pain, often linked to irritation of tendons or bursae around the greater trochanter (the bony bump on the side of your thigh bone). It was once thought to be mainly “trochanteric bursitis,” but modern research shows that tendon problems—especially in the gluteus medius and minimus—play a major role.

How common is greater trochanteric pain syndrome?

GTPS affects 10–25% of the general population at some point in their lives, with higher prevalence in women between the ages of 40–60. Risk increases in people who are overweight, those with knee or lower back problems, and athletes who perform repetitive hip movements (Fearon et al., 2013, British Journal of Sports Medicine, https://doi.org/10.1136/bjsports-2012-091565).

Daily Life Impact of Greater Trochanteric Pain Syndrome

GTPS can significantly affect your daily routines:

• Work: Sitting for long periods or standing for extended hours can trigger hip pain, limiting productivity.
• Sports and fitness: Activities like running, cycling, and climbing stairs may become painful or impossible.
• Sleep: Pain often worsens when lying on the affected hip, leading to poor sleep quality.
• Relationships & hobbies: Social activities such as long walks, dancing, or recreational sports may be disrupted.
• Mental health: Chronic pain can lead to frustration, reduced mobility, and a drop in overall well-being.

How is greater trochanteric pain syndrome different from arthritis or sciatica?

• GTPS: Pain is located on the outer hip and worsens with pressure, such as lying on the side.
• Hip osteoarthritis: Pain is usually deep in the groin and worsens with weight-bearing.
• Sciatica: Pain radiates down the leg from the lower back due to nerve irritation, rather than being localized to the hip.

Symptoms of Greater Trochanteric Pain Syndrome

The hallmark symptom of GTPS is pain and tenderness over the outer hip, often worse with movement or pressure. Symptoms can range from mild to severe, affecting daily function.

What are the main symptoms of greater trochanteric pain syndrome?

• Localized hip pain: Tenderness over the bony bump on the side of your hip.
• Night pain: Discomfort when lying on the affected side.
• Movement pain: Pain when climbing stairs, rising from a chair, running, or walking long distances.
• Radiating pain: Sometimes felt down the outer thigh but rarely past the knee.
• Weakness: Difficulty stabilizing the hip when standing on one leg.

How severe can greater trochanteric pain syndrome be?

• Mild cases: Pain occurs only after activity or with direct pressure.
• Moderate cases: Pain affects walking, sitting, or exercise, interfering with daily tasks.
• Severe cases: Pain limits mobility, disrupts sleep, and impacts quality of life.

How does greater trochanteric pain syndrome affect daily life?

• Work limitations: People in jobs requiring prolonged standing, walking, or stair climbing may struggle.
• Sport restrictions: Running, cycling, or hiking may worsen symptoms.
• Sleep disruption: Resting on the hip often increases pain, leading to fatigue.
• Mood and relationships: Ongoing discomfort can lead to irritability, reduced social participation, and stress.

Red Flag Signs – When to Seek Help

You should seek medical attention if:

• Hip pain is severe and persistent despite rest.
• Pain is accompanied by fever, unexplained weight loss, or night sweats (possible infection or systemic disease).
• Pain radiates below the knee or is associated with numbness/tingling (possible nerve involvement).

Reference:
Grimaldi, A., Mellor, R., Hodges, P., Bennell, K., Wajswelner, H., & Vicenzino, B. (2015). Gluteal tendinopathy: A review of mechanisms, assessment, and management. Sports Medicine, 45(8), 1107–1119. https://doi.org/10.1007/s40279-015-0336-5

Causes and Risk Factors for Greater Trochanteric Pain Syndrome

Greater trochanteric pain syndrome is usually caused by irritation or degeneration of the gluteal tendons, sometimes with involvement of the nearby bursae. Multiple lifestyle and biomechanical factors can increase risk.

What usually causes greater trochanteric pain syndrome?

• Overuse: Repetitive movements such as running, stair climbing, or cycling.
• Muscle imbalance: Weak gluteal muscles increase strain on tendons.
• Poor biomechanics: Leg length differences, flat feet, or pelvic instability.
• Direct pressure: Sleeping on one side without support or prolonged sitting.
• Other joint problems: Knee arthritis or lower back pain can alter walking mechanics, stressing the hip.

Who is most at risk of greater trochanteric pain syndrome?

• Women aged 40–60: Due to hormonal and biomechanical factors.
• Athletes: Especially runners and cyclists.
• Overweight individuals: Added body weight increases tendon strain.
• People with poor posture: Slouching or pelvic tilt affects hip alignment.
• Occupations: Jobs requiring prolonged standing, stair climbing, or repetitive movements.
• Pregnancy: Hormonal changes and altered gait can trigger symptoms.

Lifestyle and Biomechanical Factors

• Obesity: Raises joint load and inflammation.
• Inactivity: Weakens hip stabilizers, increasing vulnerability.
• Sudden activity increase: Rapidly starting an exercise program without conditioning.
• Poor footwear: Lack of arch support can change gait and stress the hip.

How is greater trochanteric pain syndrome different from bursitis?

Previously, outer hip pain was often labeled as “trochanteric bursitis.” However, most cases involve gluteal tendon irritation or degeneration rather than isolated bursal inflammation. That’s why the broader term “GTPS” is now preferred in clinical practice.

Reference:
Segal, N. A., Felson, D. T., Torner, J. C., Zhu, Y., Curtis, J. R., Niu, J., … & Nevitt, M. C. (2007). Greater trochanteric pain syndrome: epidemiology and associated factors. Arthritis & Rheumatism, 57(5), 967–974. https://doi.org/10.1002/art.22888

Diagnosis, Recovery, and Management of Greater Trochanteric Pain Syndrome

Greater trochanteric pain syndrome (GTPS) is diagnosed through a combination of physical exams, imaging, and clinical reasoning. Recovery depends on the severity of tendon involvement, and management strategies combine activity modification, rehabilitation, and lifestyle changes.

Diagnosis of Greater Trochanteric Pain Syndrome

GTPS is diagnosed by identifying hip pain on the outer side of the thigh bone (greater trochanter) and ruling out other causes of hip or back pain.

How do doctors test for greater trochanteric pain syndrome?

Diagnosis begins with a clinical interview and physical exam. A doctor or physiotherapist will ask about:

• When your hip pain started.
• What activities make it worse (e.g., lying on your side, climbing stairs).
• How the pain affects your daily activities such as sleep, work, and sport.

Physical examination may include:

• Palpation: Pressing over the greater trochanter to check for tenderness.
• Functional tests: Asking you to stand on one leg (single-leg stance), which often reproduces pain in GTPS.
• Strength tests: Assessing gluteal strength by resisting hip movement.
• Range of motion: Checking if stiffness or pain occurs with hip rotation.

When are imaging tests used for GTPS?

Most cases are diagnosed clinically, but imaging may be used if symptoms persist or diagnosis is uncertain:

• Ultrasound: Identifies tendon tears, thickening, or bursitis.
• MRI: Useful for detecting gluteal tendon pathology or ruling out hip joint arthritis.
• X-ray: Rules out hip osteoarthritis or bony abnormalities.

How do practitioners identify the root cause of GTPS?

The goal is not only to confirm the diagnosis but also to understand why the tendon became irritated. Contributing factors often include:

• Weakness in gluteal muscles.
• Poor pelvic control during walking or running.
• Repetitive overuse, such as long-distance running.
• Prolonged side-lying without support.
• Secondary issues like knee arthritis or lower back pain altering movement patterns.

How is GTPS different from similar conditions?

• Hip osteoarthritis: Causes groin pain and stiffness, not just outer hip pain.
• Lumbar spine pain (sciatica): May radiate past the knee with nerve symptoms like tingling or numbness.
• Trochanteric bursitis (old term): GTPS includes both bursitis and tendon involvement, so treatment is broader.

Reference:
Grimaldi, A., Mellor, R., Hodges, P., Bennell, K., Wajswelner, H., & Vicenzino, B. (2015). Gluteal tendinopathy: A review of mechanisms, assessment, and management. Sports Medicine, 45(8), 1107–1119. https://doi.org/10.1007/s40279-015-0336-5

Recovery Timeline for Greater Trochanteric Pain Syndrome

Recovery from GTPS varies widely, depending on severity, treatment, and lifestyle changes.

How long does greater trochanteric pain syndrome usually take to heal?

• Mild cases: 6–12 weeks with activity modification and basic rehab.
• Moderate cases: 3–6 months with structured physiotherapy and strength programs.
• Severe or chronic cases: 6–12+ months; may require injections or surgery in rare cases.

If/Then Decision Pathway for GTPS Recovery

• If your pain is mild and improves with short-term rest and posture adjustments, then conservative home care may be enough.
• If pain continues beyond 6–8 weeks despite rest, then structured physiotherapy is recommended.
• If symptoms persist for more than 6 months or worsen, then advanced treatments (e.g., shockwave therapy, corticosteroid injections, or surgical options) may be considered.

Factors that affect recovery

• Positive factors: Early diagnosis, consistent exercise therapy, and weight management.
• Negative factors: Ignoring symptoms, continuing aggravating activities, obesity, or poor sleep.
• Recurrence risk: Higher if you return to sport or work without correcting biomechanics or strengthening muscles.

Return to Work, Sport, and Lifestyle

• Work: Desk-based jobs may return quickly with ergonomic changes; physically demanding jobs may require longer recovery.
• Sport: Running and impact sports need gradual reintroduction, often after 3–6 months of rehab.
• Lifestyle outcomes: Most people recover fully if they follow a structured plan, but chronic cases require ongoing maintenance exercises.

Reference:
Mellor, R., Grimaldi, A., & Wajswelner, H. (2016). Exercise and load modification versus corticosteroid injection versus ‘wait and see’ for persistent gluteal tendinopathy (the LEAP trial): a randomized controlled trial. BMJ, 355, i5713. https://doi.org/10.1136/bmj.i5713

How to Manage Greater Trochanteric Pain Syndrome

GTPS management focuses on reducing pain, improving gluteal strength, correcting biomechanics, and preventing recurrence.

What’s the best way to manage GTPS at home?

Self-help & relief tips:

• Rest from aggravating activities: Avoid lying on the painful side or prolonged stair climbing.
• Ice therapy: Apply ice packs for 15–20 minutes to reduce inflammation.
• Use pillows for support: Place a pillow between knees when side-lying to reduce pressure on the hip.
• Gentle stretches: Avoid overstretching the outer hip, which can irritate tendons.
• Strengthening exercises: Start with simple glute bridges or side-lying leg lifts, progressing gradually.

Lifestyle and Prevention Strategies

• Posture: Avoid hip adduction positions (crossing legs, sitting with knees together).
• Activity modification: Replace running with swimming or cycling during painful periods.
• Footwear and ergonomics: Supportive shoes and workplace adjustments reduce hip strain.
• Weight management: Reduces pressure on hip tendons and improves long-term outcomes.

Whole-Person Management

• Exercise therapy: Core and glute strengthening for pelvic stability.
• Manual therapy: Soft tissue work or joint mobilizations may help relieve pain.
• Load management coaching: Gradual return to sport or physical activity.
• Sleep hygiene: Strategies to reduce night pain and improve rest.
• Mental health: Coping strategies for frustration and stress related to chronic pain.

How is GTPS management different from hip arthritis or bursitis?

• GTPS: Focuses on tendon strengthening and hip stabilization.
• Hip arthritis: Emphasizes joint preservation and mobility.
• Bursitis alone: Usually treated with short-term anti-inflammatories, but GTPS needs longer-term exercise rehab.

Reference:
Mellor, R., Bennell, K., Grimaldi, A., Nicolson, P., Kasza, J., Hodges, P., & Vicenzino, B. (2018). Education plus exercise versus corticosteroid injection for gluteal tendinopathy: 52-week outcomes of a randomized clinical trial. BMJ, 361, k1662. https://doi.org/10.1136/bmj.k1662

Multidisciplinary Coordinated Care for Greater Trochanteric Pain Syndrome at CARESPACE

Greater trochanteric pain syndrome (GTPS) requires more than one approach to heal effectively. At CARESPACE, your recovery is supported by a team of professionals who coordinate care across multiple disciplines, ensuring faster pain relief, long-term prevention, and support for both your physical and mental health.

How does CARESPACE treat greater trochanteric pain syndrome differently?

CARESPACE takes a team-based, multidisciplinary approach to GTPS that looks beyond short-term pain relief. Instead of focusing on only one aspect—like injections, medication, or exercise—your care is customized across different specialties to address the root cause, pain management, and lifestyle factors.

• Physiotherapy: Builds gluteal strength, restores mobility, and teaches load management strategies.
• Chiropractic care: Improves pelvic and spinal alignment to reduce compensatory stress on the hip.
• Massage therapy: Relieves muscle tightness that often develops around the hip when you alter movement due to pain.
• Kinesiology and fitness training: Provides safe, progressive exercise plans to restore stability and reduce recurrence.
• Nutrition and naturopathic medicine: Guides healthy weight management and anti-inflammatory dietary choices to reduce hip stress.
• Acupuncture: Offers natural pain relief and can calm inflammation.
• Psychotherapy and coaching: Supports stress management, motivation, and coping skills, since chronic pain often affects mood and sleep.

Why does a team approach help greater trochanteric pain syndrome recover faster?

GTPS is complex—often involving tendon irritation, biomechanical issues, and lifestyle contributors. CARESPACE’s team model ensures all these aspects are addressed at once, rather than piecemeal.

• During the acute phase: Physiotherapy, acupuncture, and massage therapy work together to reduce pain and inflammation.
• In the subacute phase: Chiropractic adjustments and kinesiology programs help restore healthy movement and stability.
• In the maintenance phase: Fitness training, nutrition coaching, and psychotherapy support long-term recovery, preventing recurrence.

This coordinated model is especially valuable for people whose hip pain interferes with sleep, work, or sport. By combining disciplines, CARESPACE helps you recover faster, return to activity sooner, and lower your risk of ongoing pain.

How does CARESPACE support the mental health side of greater trochanteric pain syndrome?

Living with GTPS is not just a physical challenge—it can also impact your mental health. Many people report frustration from disrupted sleep, reduced independence, or having to stop activities they enjoy. At CARESPACE, mental health is integrated into your plan from the start.

• Psychotherapy: Helps you process the stress and frustration of chronic pain while developing coping strategies.
• Mental performance coaching: Keeps you motivated to stick with your rehab program and lifestyle changes.
• Nutrition counseling: Supports energy, mood, and inflammation control through food choices.
• Exercise therapy: Boosts endorphins, improving mood and reducing anxiety tied to long-term discomfort.

By coordinating physical and psychological care, CARESPACE ensures you don’t just heal your hip—you rebuild confidence in your body and life.

What does a CARESPACE recovery journey for GTPS look like?

At CARESPACE, your care is personalized but generally follows three key phases:

• Acute Phase (first weeks)
  • Physiotherapy for pain control and gentle activation.
  • Massage therapy or acupuncture to calm inflammation.
  • Sleep strategies and ergonomic advice for immediate relief.
• Subacute Phase (weeks to months)
  • Chiropractic adjustments to optimize pelvic and spinal mechanics.
  • Progressive gluteal and core strengthening with kinesiology.
  • Nutrition strategies for inflammation reduction and weight management.
• Maintenance Phase (long-term)
  • Fitness training for resilience and hip stability.
  • Ongoing coaching to prevent relapse.
  • Psychotherapy to address coping, sleep, and emotional well-being.

This integrated care plan means you’re never left guessing. Each specialist contributes to your recovery, while the team communicates to ensure your treatment is seamless and effective.

Why is multidisciplinary care better than single-discipline treatment for greater trochanteric pain syndrome?

Traditional care for GTPS often focuses narrowly—such as prescribing medication or recommending rest. While this may provide temporary relief, it does not address the underlying biomechanical and lifestyle factors that cause recurrence. CARESPACE’s approach offers clear advantages:

• Faster pain relief: Combining manual therapy, acupuncture, and exercise reduces symptoms quickly.
• Root-cause correction: Strengthening gluteal muscles, improving posture, and adjusting daily habits prevents repeat flare-ups.
• Whole-person support: Physical, nutritional, and psychological factors are all integrated.
• Long-term protection: Maintenance care and lifestyle coaching lower the risk of chronic pain or disability.

This evidence-based, collaborative approach ensures that your recovery is not only quicker but also more sustainable—helping you return to sport, work, and daily life with confidence.

Related Conditions, FAQs, and Disclaimer for Greater Trochanteric Pain Syndrome

Greater trochanteric pain syndrome (GTPS) is often confused with other hip and leg conditions. To help you better understand it, this section outlines related conditions, answers common questions, and includes an important disclaimer to keep information evidence-based and safe.

Related Conditions for Greater Trochanteric Pain Syndrome

GTPS shares symptoms with several other musculoskeletal conditions, which is why professional diagnosis is so important. Pain in the hip can come from many sources, and some conditions overlap or mimic one another:

• Hip osteoarthritis: Causes stiffness and pain deep in the groin or buttock, often worsening with weight-bearing. Unlike GTPS, the pain is not usually tender over the outer hip bone.
• Lumbar spine disorders (sciatica): Can cause pain radiating down the leg, sometimes mistaken for GTPS, but nerve symptoms like tingling or numbness are more common.
• Pseudotrochanteric bursitis: An outdated label for outer hip pain; true bursitis is less common, but inflammation may still coexist with tendon irritation.
• Gluteal tendinopathy: A key part of GTPS, since weak or irritated tendons in the gluteus medius and minimus muscles often drive symptoms.
• Knee arthritis or foot problems: These can change the way you walk, leading to stress on the hip tendons and secondary pain at the greater trochanter.

For a full overview of overlapping musculoskeletal conditions, you can explore our Conditions List.

Looking for information on a different condition? Visit our full Conditions List.